Posterior Cruciate Ligament Preservation versus Posterior Cruciate Ligament Sacrifice: Comparing Patient Outcomes in Medial Congruent Total Knee Arthroplasty.

This study aimed to compare outcomes and complication rates between posterior cruciate ligament (PCL) retention and excision utilizing a medial congruent (MC) polyethylene insert in total knee arthroplasty (TKA) in a specialized ambulatory surgery center (ASC) dedicated to hip and knee arthroplasty. A retrospective review was performed between May 2023 and October 2023 analyzing 398 patients who underwent primary MC TKA by high-volume joint arthroplasty surgeons ( = 9) with either PCL preservation ( = 264) or sacrifice ( = 134) in a single free-standing ASC. Patients were matched chronologically on a 2:1 basis.

Evaluating Knee Recovery Beyond Patient Reports: A Comparative Study of Smart Implantable Device-Derived Gait Metrics Versus Patient-Reported Outcome Measures in Total Knee Arthroplasty.

Background: Total Knee Arthroplasty (TKA) is frequently performed for advanced osteoarthritis, with patient-reported outcome measures (PROMs) traditionally reporting on efficacy. These subjective evaluations, although useful, may inaccurately reflect post-TKA activity levels. With technological advancements, smart implantable devices (SIDs) offer objective, real-time gait metrics, potentially providing a more accurate postoperative recovery assessment.

A Remote Physical Therapy Program Demonstrates Similar Outcomes Compared to In-Person, Supervised Physical Therapy After Same-Day Discharge Total Knee Arthroplasty: A Randomized Clinical Trial.

Background: A growing number of total knee arthroplasty (TKA) patients are candidates for same-day discharge (SDD). Previous research has shown that internet-based remote physical therapy (RPT) can produce equivalent outcomes to supervised outpatient physical therapy (OPT) after TKA. We sought to compare outcomes between RPT and OPT in patients undergoing SDD TKA using an electronic remote perioperative management (ERPM) program.

Can Component Size in Total Knee Arthroplasty Be Predicted Preoperatively?-An Analysis of Patient Characteristics.

Accurately predicting component sizing in total knee arthroplasty (TKA) can ensure appropriate implants are readily available, avoiding complications from malsizing while also reducing cost by improving workflow efficiency through a reduction in instrumentation. This study investigated the utility of demographic variables to reliably predict TKA component sizes. A retrospective chart review of 337 patients undergoing primary TKA was performed.

Wound Management following Total Knee Arthroplasty: An Updated Review.

Optimal wound closure techniques following total knee arthroplasty (TKA) have focused on enhancing healing potential, preventing infection, yielding satisfactory cosmesis, and allowing early ambulation and functionality. An appropriate layered closure and management of the TKA typically involves addressing the (1) deep fascial layer; (2) subdermal layer; (3) intradermal layer, including the subcuticular region; and (4) final application of a specific aseptic dressing, each of which are covered here in detail. This focused critical review of the literature discusses traditional techniques used in all layers of wound closure following TKA while introducing several emerging popular techniques.

Heterotopic Ossification Following Direct Anterior Total Hip Arthroplasty With and Without Postoperative Analgesic Nonsteroidal Anti-inflammatories.

Background: Heterotopic ossification (HO) can result in poorer clinical outcomes following total hip arthroplasty (THA). Multiple modes of intervention have been evaluated for HO prevention, including the use of nonsteroidal anti-inflammatories. Additionally, multimodal pain management strategies including celecoxib have become more prominent.

Bridging the Gap: The Influence of Foot and Ankle Pathomechanics in Total Knee Arthroplasty.

Altered spinopelvic mechanics can have dramatic influences on the success of hip arthroplasty as seen with concomitant hip and spine disease. Interestingly, limited focus has been directed toward a similar codependent relationship between concurrent knee and foot deformities. By bridging this interdisciplinary gap, we attempt to explore the current understanding and clinical implications of concomitant knee and foot pathology while reviewing management options for addressing this unique yet ubiquitous patient population.

Range of Motion to Impingement Curves Create a New Patient-Specific Impingement-Free Zone for Acetabular Cup Placement.

Introduction: The acetabular "safe zone" has recently been questioned as a reliable reference for predicting total hip arthroplasty impingement and instability as many dislocations occur within the described parameters. Recently, an improved understanding of spino-pelvic mechanics has provided surgeons useful information to both identify those at a higher risk of dislocation and, in some cases, allows altering component positioning to accommodate the patient's individual "functional" range of motion. The purpose of this study was to create a new patient-specific impingement-free zone by considering range of motion (ROM) to prosthetic impingement for both high flexion and extension poses, thus demarcating a zone that avoids both anterior and posterior impingement, thereby creating an objective approach to identifying a patient's ideal functional safe zone.

The Use of New Technology for Wound Management Following Total Knee Arthroplasty: Implications for the COVID-19 Crisis.

With constantly evolving materials and techniques used in wound closure management for total knee arthroplasty (TKA), it is imperative that we continuously evaluate new modalities and techniques to optimize healing. This article provides a concise review of the current closure and wound management methods for each of the following three layers and dressing: 1) deep fascia layer, or arthrotomy; 2) subdermal layer or subcutaneous layer; 3) skin and subcuticular layer; and 4) dressing application. By introducing a comprehensive and systematic approach to TKA wounds, this report also incorporates newer modalities such as barbed sutures and adhesive dressings, which have increasingly replaced traditional suture and staple methods.

Do Antibiotic-Impregnated Intramedullary Dowels Assist in Eradicating Infection in Total Knee Arthroplasty? Pro.

Antibiotic-loaded bone cement (ALBC) spacer constructs for the treatment of periprosthetic joint infections of the knee continue to evolve from the original hockey puck designs. Countless techniques have since been described for augmentation of ALBC spacers with the use of intramedullary (IM) dowels. The use of IM dowels has become a vital addition to any knee spacer construct.